Insurance claim capitation and predictive payment modeling

ABSTRACT

A claim-based capitation model is proposed for handling vehicle repair insurance claims. Rather than determining a detailed estimate of the expected actual cost of repair, the estimate may be determined using a simpler model. For example, the insurance company and a repair facility may agree to following a predictive payment model in which the insurance company pays a fixed predicted capitated amount of money for each repair claim, regardless of the amount of repair work that will be needed. Alternatively, the insurance company may pre-pay a fixed capitated amount for a predicted number of future insurance claims.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation application that claimspriority to U.S. Provisional Patent Application Ser. No. 61/703,556,filed Sep. 20, 2012, and U.S. patent application Ser. No. 14/032,744,filed Sep. 20, 2013, both entitled “Insurance Claim Capitation andPredictive Payment Modeling,” both of which are hereby incorporated byreference as to their entirety.

BACKGROUND

Automotive insurance claims are typically handled as follows. An insuredmakes a claim, the vehicle is inspected, and it is determined whetherthe vehicle is repairable or a total loss. If the vehicle is repairable,either an insurance adjuster or a repair facility determines anestimated cost for repairing the vehicle, based on the damage sustainedto the vehicle. Thus, depending upon the vehicle and the type of damage,the estimated cost for various claims may take on a wide range ofvalues.

Unfortunately, the estimation process itself is time-consuming,expensive, and often inaccurate. Estimation of repair value typically isperformed by someone highly trained in the particulars of vehiclerepair, and given the high work load and time involved in estimation,these persons are relatively expensive to maintain. And, because theestimation is just that—an estimation—the estimate is often lateradjusted after the repair is in process or the repairs are completed toreflect actual repair costs. This can be inefficient for both theinsurer and the repair facility and can sometimes result in lengthynegotiations between the parties. This, itself, can also betime-consuming and expensive, and can induce friction in therelationship between the insurance company, the customer, and the repairfacility.

The estimation and repair process can also be complex for the insured.For example, while some insurance customers prefer the entire estimationand repair process to be turn-key such that the insurance company takescare of everything, a substantial minority of customers prefer toexercise direct control over repairs or even use the insurance paymentfor something else. However, some customers may be confused by theiroptions or even hesitant to commit to self-repair versus turn-key repairfor fear of detrimentally affecting the outcome or missing out onbenefits.

SUMMARY

A claim-based capitation model is proposed for handling vehicle repairinsurance claims. Rather than determining a detailed estimate of theexpected actual cost of repair, the estimate may be determined using asimpler model. For example, the insurance company and a repair facilitymay agree to following a predictive payment model in which the insurancecompany pays a fixed predicted amount of money for each repair claim,regardless of the amount of repair work that will be needed. By the lawof large numbers, it may be expected that an appropriately-determinedfixed amount may, in the long term, result in a fair payment for bothparties. Moreover, by potentially eliminating the detailed cost estimateand the post-repair negotiations, such a model may have the effect ofreducing overall costs to both parties. For instance, repair shops mayneed fewer qualified estimation and negotiation resources, and insurancecompanies may also need fewer oversight and negotiation resources.

In a variation of the above model, the payment amount may not beentirely fixed across all vehicle claims, however the payment amount maybe based on a pricing process that may be much simpler than thetraditional estimation process. The pricing process may not even bebased on an actual inspection of the vehicle (e.g., by a personphysically inspecting damage to the vehicle). Rather, the amount to bepaid to a repair shop for a given claim may be determined (e.g.,predicted) based on a predictive and/or heuristic model. For instance,the amount to be paid may be determined based at least in part on one ormore loss attributes of the claim, where each loss attribute may itselfbe associated with a particular fixed amount of money. Such lossattributes may include, for example, make, model, and/or year of thevehicle; type of damage or event (e.g., front-end collision, rear bumperdamage, etc.), origin of manufacture of the vehicle (e.g., domestic,European, Asian, etc.); place of occurrence of the event (e.g., parkinglot, intersection, highway, region of country, etc.); date of occurrenceof the event; point of impact to the vehicle (e.g., rear, side, front,corner); volume and/or frequency of the particular claim type; severityof damage, speed at impact, amount of acceleration and/or decelerationprior to impact, whether braking was applied prior to the impact,whether the vehicle is drivable after the incident, whether the air bagof the vehicle deployed, any vehicle black box data, any other on-boardvehicle computer data that may provide any of the above information,such as from GPS electronics, driving habit analysis electronics (e.g.,Allstate's DRIVEWISE system), any information from other computingdevices in the vehicle that may or may not be integrated with thevehicle (e.g., smart phones, tablet computers, laptop computers,personal fitness sensors, etc., that may include accelerometers, GPSdevices, shock sensors, and the like), and/or insurance coverage of theinsured. These are merely examples, and so additional and/or alternativeloss attributes may be used. As another example, the payment amount maybe established by first classifying a claim into a range of paymentsthat are applicable based on conditions to be assessed by the repairfacility and validated by the insurance company. For example, a claim offront end damage may be classified in a range of $X to $Y, where theactual amount in that range ultimately depends upon whether the radiatormust be replaced.

According to further aspects, the determined payment (e.g., the fixedpayment or the loss-attribute-determined payment) may be paid to therepair facility up front. For example, the determined payment for agiven claim may be paid to the repair facility before the repair hasbegun, before the vehicle has been received by the repair facility, orat any time during the claim. In further aspects, the payment may beprovided even before the claim has been made by the insured. This mayoccur in a bulk process, for instance, where a repair facility ispre-paid for X number of repair claims per time period (e.g., per month,per quarter, or per year). If the repair shop is able to be paid earlierin the claims process, then the repair shop may be able to benefit fromthis such as by having the ability to invest the money in the businessat an earlier stage. This may benefit both the repair facility and theinsurance company in the long run, as it may allow the repair facilityto make better business decisions, follow up with long-term planningwith greater financial stability, and generally result in a potentiallymore cost-efficient repair business. Other potential benefits to therepair facility by receiving forecasted demand and prepayment for atleast some types of repairs may ability to manage staff hiring and/ortraining, improved capacity to manage the parts supply chain, and/orimproved capacity to manage parts costs.

According to still further aspects, the insurance company may be able tomake predictions, on a customer-by customer basis, as to which customersare likely to want to self-repair versus those customers that are likelyto want a turn-key repair process directed by the insurance company.Insurance companies may use the predictions to present offers tocustomers in response to the first notice of loss, thereby potentiallyproviding improved customer service. For instance, the offers may be topresent a customer with a check, or to recommend a particular repairshop contracted by the insurance company, or to recommend which partsthe customer might purchase and/or certain repair procedures.

These features are merely examples, and these and other features anddetails will be discussed below in the Detailed Description section ofthis paper. It is also noted that, while vehicle insurance claims arediscussed in the various examples herein, the capitation modelsdiscussed herein may also be applied to other types of insurance claims,such as but not limited to homeowner insurance claims, renter'sinsurance claims, boat insurance claims, aircraft insurance claims, andpersonal property insurance claims in general.

BRIEF DESCRIPTION OF THE DRAWINGS

Some features herein are illustrated by way of example, and not by wayof limitation, in the figures of the accompanying drawings and in whichlike reference numerals refer to similar elements.

FIG. 1 is a block diagram of an example insurance claim environment thatmay be used in accordance with aspects as described herein.

FIG. 2 is a block diagram of an example computing device that may beused to embody or otherwise implement any of the elements and functionsdiscussed herein.

FIG. 3 is a flow chart of an example process that may be performed inaccordance with one or more aspects as described herein.

FIG. 4 is a flow chart of another example process that may be performedin accordance with one or more aspects as described herein.

FIG. 5 is a flow chart of still another example process that may beperformed in accordance with one or more aspects as described herein.

DETAILED DESCRIPTION

FIG. 1 is a block diagram of an example insurance claim environment thatmay be used in accordance with aspects as described herein. Theenvironment in this example includes an insurance company and one ormore repair facilities. While only a single repair facility is shown inFIG. 1, it will be understood that there may be multiple differentrepair facilities in the environment, and each may be configured such asin the manner of the shown repair facility. Each repair facility may be,for example, an automobile repair garage that is dedicated for thatpurpose or that is included as part of a larger business such as a cardealer, a tire dealer, a gas station, a store, or the like.

The insurance company may have or otherwise control one or morecomputing and data storage resources for performing various functionsrelated to insurance claims processing. In this example, the insurancecompany may have or otherwise control at least a claim processing system101, a maintenance system 102, a data storage system 103, and anaccounting system 107. It will be understood that the insurance companyis likely to have other types of systems as well. The repair facilitymay have or otherwise control a repair tracking system 104, a datastorage system 105, and an accounting system 108. Any of the systems ofthe insurance company and the repair facility may communicate with eachother by sending information (e.g., electronically and/or physically)back and forth via a network 106.

The various systems 101, 102, 104, 107, and 108 may include or otherwisebe embodied as one or more computing devices, such as one or moreservers, personal computers, tablet computer, and the like, and/or oneor more humans performing various tasks. Moreover, while each of theelements 101-108 are shown in FIG. 1 as separate elements, theseelements may be physically and/or logically combined in any combinationor subcombination, and/or further physically and/or logicallysub-divided. For example, a single computing device may act as both themaintenance system 102 and the claim processing system 101, and/or asportions of one or both. The term “computing device” is broadly usedherein to include both a single device (e.g., a single server) as wellas multiple devices that work together (e.g., a plurality of serversand/or personal computers).

Claim processing system 101 may be responsible for processing incomingclaims (e.g., in the form of data), and for making a determination as tohow to process those claims. Information that may be used by claimprocessing system 101 may include the incoming claim information,information retrieved from data storage 103, information received frommaintenance system 102, and/or information received from repair trackingsystem 104.

Maintenance system 102 may be responsible for maintaining theinformation (e.g., data) stored by data storage 103, including updatingthe information as needed. Maintenance system 102 may maintain theinformation stored by data storage 103 on the basis of received externaldata, data stored in data storage 103, and/or information received fromclaim processing system 101.

Network 106 may be any one or more networks, and may include one or morenetwork types. Non-limiting examples of networks from which network 106may be comprised may include the Internet, an intranet, a local areanetwork, a wide-area network, a wired network (e.g., a landlinetelephone network, and Ethernet network, etc.), a wireless network(e.g., an IEEE 802.11 compliant network, a BLUETOOTH network, a cellularnetwork, etc.), and an optical network. Network 106 may additionally oralternatively include one or more non-electronic networks fortransferring information in physical form, such as a mail courier (e.g.,the U.S. Postal Service, UPS, Federal Express, etc.).

Repair tracking system 104 may be responsible for keeping track ofexpected, current, and/or completed repairs performed by the repairfacility. Information that may be tracked may include, for instance,information about the claim with which the repair is associated, thedate and/or timeframe of the repair, the amount paid (or to be paid) bythe insurance company for the repair, the estimated cost for the repair,the actual cost incurred for performing the repair, information aboutthe vehicle customer, information about the vehicle, and/or any otherinformation as desired. Such information may be stored in data storage105.

Data storage 103 and 105 may be physically separate from the otherelements 101, 102, 104, 107, and/or 108. For instance, data storage 103and/or 105 may be embodied as racks of tape storage drives and/or harddrives. Alternatively, one or more of data storage 103 and/or 105 may bepartially or fully integrated with one or more of the other elements101, 102, 104, 107, and/or 108. For instance, data storage 103 and/or105 may be embodied as hard drives, memory, and/or othercomputer-readable storage media that are at least partially part of oneor more of the computing devices of any of elements 101, 102, 104, 107,and/or 108. Moreover, data storage 103 and data storage 105 may eachinclude one or more computer-readable data storage devices, which may inturn include one or more computer-readable storage media. In addition,each of data storage 103 and data storage 105 may include or beinterfaced by a database system that can be queried to update and/orretrieve data to/from data storage 103 and/or 105.

The accounting systems 107 and 108 may each be responsible formaintaining an accounting of payments made by the insurance companyversus payments owed to the repair facility. The accounting systems 107and 108 may be separate systems and/or they may be part of claimprocessing system 101 and/or repair tracking system 104. Moreover, theaccounting system(s) 107 and/or 108 may be maintained by a third partyif desired, such as by a bank or other financial institution.

FIG. 2 illustrates an example of general hardware and/or softwareelements that can be used to partially or fully embody any of thevarious devices and functions discussed herein, such as any of thoseelements discussed herein with regard to FIG. 1. A computing device 200(also often referred to as a computer) may include one or moreprocessors 201, which may execute instructions of a computer program toperform any of the features described herein. The instructions may bestored in any type of tangible and/or non-transitory computer-readabledata storage device 202 (which may include one or more computer-readablestorage media, such as a memory or hard drive) to configure theoperation of the processor 201. For example, instructions may be storedin a read-only memory (ROM), a random access memory (RAM), a removablemedia such as a Universal Serial Bus (USB) drive, compact disk (CD) ordigital versatile disk (DVD), a floppy disk drive, an attached (orinternal) hard drive, and/or any other desired data storage medium. Thecomputing device 200 may include or be coupled to one or more outputdevices, such as a display device 205 (e.g., an external television, ora computer monitor), and may include one or more output devicecontrollers, such as a video processor. The display device 205 may bephysically separate from the computing device 200, or it may beintegrated with the remainder of the computing device 200. There mayalso be one or more user input devices, such as a remote control,camera, keyboard, mouse, touch screen, microphone, etc. The computingdevice 200 may also include a communication interface 204, which mayinclude one or more input and/or output circuits (e.g., in the form of anetwork card) to communicate with an external device or network (e.g.,network 106). The communication interface 204 may include one or morewired interfaces, wireless interfaces, or a combination of the two.

FIG. 3 is a flow chart of an example process in accordance with one ormore aspects as described herein. The various steps in the flow chartmay be performed by one or more devices and/or humans, such as any ofthe elements of FIG. 1. While certain steps may be described below asbeing performed by a specific element, it will be understood that thisis merely an example, and that each step may be performed by alternativeelements. Moreover, while the steps are shown in a particular order anddivided into specific steps, it will be understood that the order may bemodified, and that one or more of the steps may be combined and that oneor more of the steps may be further sub-divided into further steps.

At step 301, the insurance company may receive an incoming new orrevised claim. This may occur by, for instance, receiving and/orgenerating data representing characteristics of the claim, such as adescription of the claim, an identification of the property (e.g.,vehicle) affected by the claim, an identification of the insured, andidentification of the type and/or extent of damage to the property, andidentification of the timeframe (e.g., time, date, etc.) at which thedamage occurred and/or when the claim is made, and/or any otherinformation as desired. The data may be generated by and/or provided to,for instance, claim processing system 101.

At step 302, the claim may be validated, such as by physical inspectionof the property (e.g., vehicle) to confirm the claimed damage, theexistence of the property, and/or other issues that may be associatedwith a claim. Validating a claim may additionally or alternativelyinclude, for instance, receiving one or more of the following inputsfrom the insured customer, an agent or another representative of theinsurance company, and/or the repair facility: images of damage,descriptions of damage guided by a form or system, or free-formdescriptions of damage. Any of those inputs may be analyzed by a system(such as claim processing system 101), such as according to a predictivepayment model, to validate the claim, classify the nature of the claimor damage or repair needed, and/or establish a preliminary or finalpayment amount or range.

Validation may also involve determining whether the property canreasonably and/or cost-effectively be repaired (e.g., whether theproperty is repairable), or whether the property is considered “totaled”and no repair is to be made under the insurance contract. If it isdetermined that the property is repairable, then the process may move tostep 303. Step 302 may be performed prior to sending the property to therepair facility (and by a party other than the repair facility such asan insurance adjuster), or it may be performed by the repair facilityitself during, for instance, step 307.

At step 303, the payment amount to be made to the repair facility forthe claim may be determined by, for instance, claim processing system101, in accordance with a predetermined model. As previously discussed,the determination may be of a fixed amount defined by the model thatdoes not vary from claim to claim (or at least from automotive repairclaim to automotive repair claim). Thus, for example, a claim for aside-view mirror replacement may result in the same determined paymentamount as a claim for a bumper replacement and re-painting and as aclaim for body work performed on a vehicle. The determined paymentamount may thus already be predetermined at the time that step 303 isperformed, and data representing the predetermined payment amount may bestored in a data storage device, such as data storage 103 and/or as partof claim processing system 101.

Alternatively, the payment amount may be determined according to aparticular model, referred to herein by way of example as a predictivepayment model. The predictive payment model may be predetermined and/ordynamic, and may be stored as data and/or computer-executableinstructions in a computer-readable storage medium such as data storage103, and may be executed or otherwise implemented by one or morecomputers such as claim processing system 101.

The predictive payment model may include a payment schedule, in whichthe determined payment amount may vary depending at least upon theparticular characteristics of the claim. In this case, the paymentamount may be determined based at least on information (e.g., thepayment schedule) stored in data storage 103 and/or information providedby maintenance system 102. For instance, the payment schedule stored indata storage 103 may associate each of a plurality of predetermined lossattributes with an effect on the determined cost. In this case,determination of the payment amount may include determining which of theloss attributes apply to the present claim. For example, if two of thepredetermined loss attributes are (1) European car and (2) American car,and the claim is for damage to an American car, then the loss attribute“American car” may apply to that claim.

One or more of the loss attributes may be associated in data storage 103(e.g., via a database) with a particular cost, and so the finaldetermined payment amount may be based at least on a sum of thoseparticular costs for the appropriate loss attributes of a claim. One ormore of the loss attributes may additionally or alternatively beassociated in data storage 103 with a particular multiplier, and so thefinal determined payment amount may additionally or alternatively bebased at least on one or more costs being multiplied by one of themultipliers.

For example, assume that at least the following predetermined attributesare stored in data storage 103 and associated with the following costsand/or multipliers, as shown below in the example payment schedule ofTable 1.

TABLE 1 Example Payment Schedule Loss Attribute Associated CostAssociated Multiplier European car M1 American car M2 side view mirrorC1 front bumper C2 frontal collision M4 . . . . . . . . .

If the claim is for an American car that needs a new front bumper and aside view mirror, then in this simplified example, the payment amount Pfor the claim may be based at least on the following calculation:M2*(C1+C2). Of course, the payment amount may depend upon other factorsand other loss attributes. Moreover, the particular calculation is onlyan example, and loss attributes may affect the determined payment inother ways. Moreover, the multipliers do not need to necessarily affectall associated costs, and so the stored data of data storage 103 mayfurther associate each multiplier with a list or class of lossattributes to be multiplied with. In general, one may consider each lossattribute to be associated with at least one value that may contributeto the final determined payment amount, and one may envision manypossible ways in which the loss attribute values may be combined todetermine the payment amount.

At step 304, a prediction may be made by, e.g., the claim processingsystem 101, as to whether the customer is likely to want to self-repairor undergo insurance company directed repair. As mentioned previously,for a given random population of insurance customers, there is typicallya significant minority of customers that are comfortable managingvehicle repair on their own (e.g., repairing the vehicle itself orworking with an auto body shop) or that otherwise desire to simplyreceive a direct monetary payment for the loss. The remaining customersmay not be so comfortable managing their own repairs and would prefer tohave the repair performed with the oversight of the insurance company oragent. It may be desirable for the insurance company to be able todistinguish between these two customer segments, and in particular to beable to predict, on a customer-by-customer basis, whether the customerwould likely prefer to self-manage (including simply receiving amonetary payment) or obtain the repair under the management of theinsurance company.

The prediction made at step 304 may be used as a factor in determiningan offer to the customer in response to the first notice of loss. Forexample, if the customer is predicted to be a self-repair customer, thenthe offer may be to present a customer with a check of a determinedamount of money, and/or to recommend which parts the customer mightpurchase and/or certain repair procedures customized to the particulardamage done to the vehicle and/or customized to the particular vehicle.On the other hand, if the customer is predicted to be a turnkey customer(e.g., preferring to let the insurance company handle the repair), theoffer may be to recommend a particular repair shop contracted by theinsurance company. While step 304 is shown between steps 303 and 305,step 304 may be performed at any time. For instance, if the monetaryamount offered to the customer as a check (where the customer ispredicted to be a self-repair customer), the amount offered may or maynot be the same amount as predicted using the predictive payment modelat step 303. If not, then there may be no need to perform step 303 forthat customer.

The prediction of whether a customer is likely to be a self-repaircustomer or a turnkey customer may depend upon any of one or morefactors. Examples of such factors may include the customer's age,gender, employment, job title, income, vehicle make/model, educationlevel, family size, geographical location, magazine subscriptions (e.g.,technical magazine subscriptions may make it more likely that thecustomer is interested in self-repair), a history of previous insuranceclaims and whether the claims resulted in self-repair versus turnkeyrepair, the customer's proximity to an appropriate and/or contractedrepair shop, the complexity and/or type of repair needed, the type ofdamage done to the vehicle, and/or the severity of the damage done tothe vehicle. By creating a statistical model based on one or morefactors such as (but not limited to) those listed above, it may bepredicted, for a given customer, whether the customer is more likely todesire a self-repair process or a turnkey process. For instance,customers living in cities may be more likely to want a turnkey processas opposed to customers living in rural areas; customers of various agegroups may be more or less likely to want a particular repair process;customers with foreign luxury cars may be more likely than customerswith domestic non-luxury cars to want a turnkey process; customers withtechnical jobs and/or technology-related educations may be more likelyto prefer self-repair, etc.

At step 305, based on the result of the prediction made at step 304, itmay be determined (e.g., by the claim processing system 101) whether thecustomer is likely to be a self-repair customer or a turnkey customer.If turnkey, then the process may move to step 309, in which the systemmay generate and present a turnkey repair offer to the customer (e.g.,in the form of physical paper, an electronic communication, a telephonecall, etc.). The turnkey repair offer may include, for example, anindication of the determined cost of repair, the determined repairslikely needed, one or more repair shops acceptable to the insurancecompany, and the like. If the offer is accepted by the customer at step310, then the process may move to step 306. If the offer is not acceptedby the customer, then the process may move to step 311, in which anegotiation process may be performed to determine an outcome acceptableto both the customer and the insurance company.

Returning to step 305, if the customer is predicted to be a self-repaircustomer, then the process may move to step 312, in which a monetaryoffer may be generated and presented to the customer (e.g., in the formof physical paper, an electronic communication, a telephone call, acheck for an offered amount, etc.). The monetary amount may be theamount determined at step 303 (if that step is performed), or it may bea different amount. If the offer is accepted by the customer at step313, then the process may move to step 315, in which the offered amountof money is provided to the customer (such as in the form of a check,electronic transfer, credit, and the like). If the offer is not acceptedby the customer, then the process may move to step 315, in which anegotiation process may be performed to determine an outcome acceptableto both the customer and the insurance company.

Assuming that the customer accepts a turnkey offer at step 310, then atstep 306, the determined payment amount is actually paid to the repairshop. Payment may be performed physically (e.g., via physical currency)and/or electronically (e.g., via transfer to a bank account, and/or viarecording the payment amount to an account of the repair shop). It isnote that payment does not actually need to occur between steps 305 and307, and may occur at any time. In this example, the payment may be madeat any time once the payment amount for the claim has been determined.For example, payment may be made periodically for a batch of claims,rather than on a claim-by-claim basis.

At step 307, the repair shop may perform the needed repair on thevehicle and/or other property covered by the claim. If the vehicle hasnot already been transported to the repair shop at an earlier step (suchas during validation at step 302), then the vehicle may be transportedto the repair shop. Once the repair is complete, the vehicle may bereturned to the vehicle owner.

At step 308, the repair shop may maintain repair data, such as viarepair tracking system 104 (and which may be stored by data storage105). The repair data may include any information about the claim and/orabout the repair made. For instance, the repair data may includeinformation about the claim with which the repair is associated, thedate and/or timeframe of the repair, the amount paid (or to be paid) bythe insurance company for the repair, the estimated cost for the repair,the actual cost incurred for performing the repair, information aboutthe vehicle customer, information about the vehicle, informationdetailing what was involved in the repair (e.g., parts and/or labor),and/or any other information as desired. This information may beprovided to the insurance company (e.g., to claim processing system 101)on a continuous or intermittent (e.g., periodic) basis. During step 308,the repair facility and/or the insurance company may also update theiraccounting systems 107 and/or 108 to reflect that a claim has beencompleted to repair.

As will be described further below, the insurance company may use therepair and/or accounting data to update the information stored in datastorage 103 and/or to update the algorithms used to determine thepayment amount in future claims.

In addition, as part of step 308 and/or at any other time, the qualityof repairs that have been made (or that are in process) may be managedby various means such as spot inspections by the insurance company or athird party or through customer satisfaction surveys. Anotherpossibility may be to require that the repair facility provide awarranty of each repair. The characteristics of the warranty program andprocess may be agreed to by the repair facility and insurance companyand covered by the agreed payment amounts. The warranty program may beunderwritten by a third party and adjudicated by the insurance company,or it may be adjudicated by the warranty company or another party agreedto by the insurance company, repair facility, and warranty company.

FIG. 4 is a flow chart of another example process in accordance with oneor more aspects as described herein. The various steps in the flow chartmay be performed by one or more devices and/or humans, such as any ofthe elements of FIG. 1. While certain steps may be described below asbeing performed by a specific element, it will be understood that thisis merely an example, and that each step may be performed by alternativeelements. Moreover, while the steps are shown in a particular order anddivided into specific steps, it will be understood that the order may bemodified, and that one or more of the steps may be combined and that oneor more of the steps may be further sub-divided into further steps.

At step 401, rather than paying a specific amount for a claim (or inbulk for a group of claims) after the incoming claims have beenreceived, the process may involve partial or full pre-payment ofpredicted payment amounts for one or more future expected claims. Thetotal payment amount in step 401 may be determined according to thepredictive payment model in any of the ways discussed previously withregard to step 303, except in this case the payment amount may bedetermined based on predicted hypothetical future claims.

At step 402, the insurance company may receive an incoming new orrevised claim. As previously described with regard to step 301, receiptof an incoming claim may occur by, for instance, receiving and/orgenerating data representing one or more characteristics of the claim.Again, the claim data may be generated by and/or provided to, forinstance, claim processing system 101.

At step 403, the claim may be validated, such as by physical inspectionof the property (e.g., vehicle) to confirm the claimed damage, theexistence of the property, and/or other issues that may be associatedwith a claim. Validation has already been described in connection withstep 302, and may also be performed in the same manner here. Moreover,step 403 may be performed prior to sending the property to the repairfacility (and by a party other than the repair facility such as aninsurance adjuster), or it may be performed by the repair facilityitself during, for instance, step 406.

At step 404, a prediction may be made in a similar manner as in step 304by, e.g., the claim processing system 101, as to whether the customer islikely to want to self-repair or undergo insurance company directedrepair.

As in step 304 discussed previously, the prediction made at step 404 maybe used as a factor in determining an offer to the customer in responseto the first notice of loss. Moreover, while step 404 is shown betweensteps 403 and 405, step 404 may be performed at any time.

As in the process of FIG. 3, the prediction in the process of FIG. 4 ofwhether a customer is likely to be a self-repair customer or a turnkeycustomer may depend upon any of one or more factors, such as thosepreviously discussed. The statistical model previously discussed may beused to predict, for a given customer, whether the customer is morelikely to desire a self-repair process or a turnkey process.

At step 405, based on the result of the prediction made at step 404, itmay be determined (e.g., by the claim processing system 101) whether thecustomer is likely to be a self-repair customer or a turnkey customer.If turnkey, then the process may move to step 409, in which the systemmay generate and present a turnkey repair offer to the customer (e.g.,in the form of physical paper, an electronic communication, a telephonecall, etc.). The turnkey repair offer may include, for example, anindication of the determined cost of repair, the determined repairslikely needed, one or more repair shops acceptable to the insurancecompany, and the like. If the offer is accepted by the customer at step410, then the process may move to step 406. If the offer is not acceptedby the customer, then the process may move to step 411, in which anegotiation process may be performed to determine an outcome acceptableto both the customer and the insurance company.

Returning to step 405, if the customer is predicted to be a self-repaircustomer, then the process may move to step 412, in which a monetaryoffer may be generated and presented to the customer (e.g., in the formof physical paper, an electronic communication, a telephone call, etc.).If the offer is accepted by the customer at step 413, then the processmay move to step 415, in which the offered amount of money is providedto the customer (such as in the form of a check, electronic transfer,credit, and the like). If the offer is not accepted by the customer,then the process may move to step 415, in which a negotiation processmay be performed to determine an outcome acceptable to both the customerand the insurance company.

Assuming that the customer accepts a turnkey offer at step 410, then atstep 406, the repair shop may perform the needed repair on the vehicleand/or other property covered by the claim. If the vehicle has notalready been transported to the repair shop at an earlier step (such asduring validation at step 403), then the vehicle may be transported tothe repair shop. Once the repair is complete, the vehicle may bereturned to the vehicle owner.

At step 407, the repair shop may maintain the previously-describedrepair data, such as via repair tracking system 104 (and which may bestored by data storage 105). As previously described, the repair datamay include any information about the claim and/or about the repairmade. This information may be provided to the insurance company (e.g.,to claim processing system 101) on a continuous or intermittent (e.g.,periodic) basis.

During step 407, the repair facility and/or the insurance company mayalso update their accounting systems 107 and/or 108 to reflect that aclaim has been completed to repair. Where pre-payment has been made,such as in step 401, this may involve tracking how many claims have beencompleted versus how many have been pre-paid. If the pre-paid amount isdeemed to be insufficient (e.g., if all predicted claims have beencompleted or are otherwise in process), then the insurance company mayagain perform step 401 to make an additional pre-payment for stillfurther future claims.

As shown in FIG. 4, the claim process may repeated as desired, such asfor the duration that the pre-payment amount from step 401 is sufficientto cover repair of the claims. Moreover, as will be described furtherbelow, the insurance company may use the repair and/or accounting datato update the information stored in data storage 103 and/or to updatethe algorithms used to determine the payment amount for future batchesof predicted claims.

FIG. 5 is a flow chart of still another example process that may beperformed in accordance with one or more aspects as described herein.The various steps in the flow chart may be performed by one or moredevices and/or humans, such as any of the elements of FIG. 1. Whilecertain steps may be described below as being performed by a specificelement, it will be understood that this is merely an example, and thateach step may be performed by alternative elements. Moreover, while thesteps are shown in a particular order and divided into specific steps,it will be understood that the order may be modified, and that one ormore of the steps may be combined and that one or more of the steps maybe further sub-divided into further steps.

As previously explained, the insurance company may use the repair and/oraccounting data to update the information stored in data storage 103and/or to update the algorithms used to determine the payment amount forfuture submitted claims (in the case of payment after claim submissionsuch as in FIG. 3) and/or for future expected hypothetical claims (inthe case of pre-payment such as in FIG. 4). An example of how this maybe accomplished is described in connection with FIG. 5.

At step 501, the insurance company may receive the repair and/oraccounting data provided by the repair facility during, for instance,steps 308 and/or 407. The data may be received at any system of theinsurance company, such as claim processing system 101, maintenancesystem 102, and/or accounting system 107.

At step 502, the insurance company may further receive or otherwiseobtain any other data, which may be external data (e.g., from a thirdparty separate from the insurance company) and/or internal data (e.g.,data generated by or previously obtained by the insurance company). Thisadditional data may include, for instance, information about claims byother insurance companies, news items, insurance statistics, profitmargins, and/or vehicle sensor data (e.g., accelerometer, GlobalPositioning System, speed, etc.) that was collected during the incidentleading to the claim. Any of such data may influence the predictivepayment model and/or be used as inputs to the predictive payment model.Steps 501 and 502 may be performed at any time and in any particularorder (even simultaneously and/or on a continuous or intermittentbasis). These steps are shown in a particular order only as an example.

At step 503, the insurance company may determine whether and/or how torevise the predictive payment model stored in data storage 103. Such adetermination may be performed by, for instance, maintenance system 102.The determination may be made based on one or more factors. Forinstance, it may be determined that the insurance company is lessprofitable than expected, or that the insurance company may even belosing money, based on the current predictive payment model.Additionally or alternatively, it may be determined (such as based onthe external data) that the costs of parts for repairs are rising. Inresponse to determinations such as these, maintenance system 102 maydetermine that the predictive payment model should be revisedaccordingly (so that, for instance, the average payments to repairfacilities are higher). Of course, the opposite may be true—if theinsurance company determines that the predictive payment model could beadjusted so that payments to the repair facilities are, on average,lower, then the predictive payment model could be revised accordingly aswell.

At step 504, the predictive payment model as stored in data storage 103may be revised in the determined manner, such as by maintenance system102. As future claims and/or payments are made, the revised predictivepayment model may be used going forward. The process of FIG. 5 may berepeated as desired on an ongoing basis. For instance, the process ofFIG. 5 may be continuously performed and/or on an intermittent (e.g.,periodic) basis, such as monthly, quarterly, or annually.

The various features described above are merely non-limiting examples,and can be rearranged, combined, subdivided, omitted, and/or altered inany desired manner.

The invention claimed is:
 1. A system for efficiently using computing resources to process insurance claims, comprising: a processor; a non-transitory computer-readable medium storing instructions that, when executed by the processor, cause the system to: store, in the non-transitory computer-readable medium, first data representing a model, wherein the model associates a first set of loss attributes of a plurality of loss attributes with a plurality of multipliers and associates a second set of loss attributes of the plurality of loss attributes with a plurality of costs; receive, via a communication network, second data that comprises information about a vehicle and that comprises vehicle sensor data generated by a sensor device of the vehicle; select, based on the second data, at least a first loss attribute from the first set of loss attributes and at least a second loss attribute from the second set of loss attributes; determine a capitated cost of repair of the vehicle based on one or more of the plurality of multipliers associated with the at least the first loss attribute and based on one or more of the plurality of costs associated with the at least the second loss attribute; identify one or more factors of a customer associated with the vehicle to create a statistical model with the one or more factors; predict, based on the statistical model in response to a first notice of loss, whether the customer associated with the vehicle is likely to allow an insurance company to manage repair of the vehicle; and transmit a payment to a repair facility responsive to a determination that the customer associated with the vehicle has accepted an offer transmitted to the customer, wherein the offer is transmitted upon a prediction that the customer will let the insurance company manage the repair and wherein the payment includes an amount based on the capitated cost.
 2. The system of claim 1, wherein the non-transitory computer readable medium stores instructions that, when executed by the processor, further cause the system to: initiate, at the repair facility, repair of the vehicle for the capitated cost.
 3. The system of claim 1, wherein determination of the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle without inspecting actual damage to the vehicle.
 4. The system of claim 1, wherein the non-transitory computer readable medium stores instructions that, when executed by the processor, further cause the system to: receive third data from the repair facility indicating an actual cost of repair; and revise the model based on the third data.
 5. The system of claim 1, wherein determination of the capitated cost of repair of the vehicle is performed in response to a first notice of loss of an insurance claim for the vehicle.
 6. The system of claim 1, wherein the sensor device comprises a sensor and an on-board computing device communicatively coupled with the sensor.
 7. The system of claim 1, wherein the sensor device comprises an accelerometer of the vehicle and the vehicle sensor data comprises acceleration data in accordance with a measurement of the accelerometer.
 8. The system of claim 1, wherein a determination of the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle based on the second data and historical costs.
 9. The system of claim 1, wherein the sensor device comprises a global positioning system sensor of the vehicle and the vehicle sensor data comprises data indicating one or more locations of the vehicle.
 10. The system of claim 1, further comprising the sensor device of the vehicle.
 11. An apparatus for efficiently using computing resources to process insurance claims, comprising: a processor; a non-transitory computer-readable medium storing instructions that, when executed by the processor, cause the apparatus to: store, in the non-transitory computer-readable medium, first data representing a model, the model associating one or more first loss attributes with a plurality of multipliers and associates one or more second loss attributes with a plurality of costs; receive, via a communication network, vehicle sensor data that comprises information about a vehicle and is generated by a sensor device of the vehicle; select, based on the vehicle sensor data, a first loss attribute from the one or more first loss attributes and at least a second loss attribute from the one or more second loss attributes; determine a capitated cost of repair of the vehicle based on the plurality of multipliers associated with the first loss attribute and based on one or more of the plurality of costs associated with the second loss attribute; identify one or more factors of a customer associated with the vehicle to create a statistical model with the one or more factors; transmit, to the customer, responsive to a prediction that the customer associated with the vehicle is likely to allow an insurance company to manage repair of the vehicle, an offer to repair the vehicle, wherein the prediction is generated based on the statistical model in response to a first notice of loss; and transmit a payment to a repair facility responsive to a determination that the customer associated with the vehicle has accepted an offer transmitted to the customer.
 12. The apparatus of claim 11, wherein the non-transitory computer readable medium stores instructions that, when executed by the processor, further cause the apparatus to: initiate, at the repair facility, repair of the vehicle for the capitated cost.
 13. The apparatus of claim 11, wherein determination of the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle without inspecting actual damage to the vehicle.
 14. The apparatus of claim 11, wherein the non-transitory computer readable medium stores instructions that, when executed by the processor, further cause the apparatus to: receive third data from the repair facility indicating an actual cost of repair; and revise the model based on the third data.
 15. The apparatus of claim 11, wherein determination of the capitated cost of repair of the vehicle is performed in response to a first notice of loss of an insurance claim for the vehicle.
 16. The apparatus of claim 11, wherein the sensor device comprises a sensor and an on-board computing device communicatively coupled with the sensor.
 17. The apparatus of claim 11, wherein the sensor device comprises an accelerometer of the vehicle and the vehicle sensor data comprises acceleration data in accordance with a measurement of the accelerometer.
 18. The apparatus of claim 11, wherein a determination of the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle based on the vehicle sensor data and historical costs.
 19. The apparatus of claim 11, wherein the sensor device comprises a global positioning system sensor of the vehicle and the vehicle sensor data comprises data indicating one or more locations of the vehicle. 